Zeitschriftenartikel: „Specialized Education and Home Care Services“

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SALEH, Mira BOU, Olivier GRUNDER und Amir HAJJAM EL HASSANI. „Mixed-Integer Linear Programming for Specialized Education and Home Care Services“. IFAC-PapersOnLine 55, Nr. 10 (2022): 3130–35. http://dx.doi.org/10.1016/j.ifacol.2022.10.210.

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Kadar, Kusrini Semarwati, Fitrah Ardillah, Arnis Puspitha und Erfina Erfina. „Implementation of Home Care Services by Community Health Centers (Puskesmas) in Makassar City, Indonesia“. Jurnal Keperawatan Indonesia 25, Nr. 1 (30.03.2022): 32–41. http://dx.doi.org/10.7454/jki.v25i1.1695.

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Home care services by health professionals, such as doctors, nurses, and other health care professionals, target to provide health care services, including health education, physical examination, or other treatments such as physical therapy or medication. This study aimed to evaluate the implementation of home care (nursing care and home care services) in Makassar City in accordance with government guidelines. A qualitative descriptive study was conducted by interviewing nurses (15 participants) from several community health centers (Puskesmas) in Makassar City, Indonesia who have implemented a home care program for at least a year. Four main themes had emerged, namely, management of home care services, nurses’ roles in home care services, perceived barriers, and community benefits. Despite some barriers, the home care programs delivered by health care professionals including nurses in Puskesmas in Makassar City have been well implemented in accordance with the guidelines. On the basis of the obstacles faced by the nurses, one recommendation is for the government to provide specific guidelines on the types of patients to be included in these services. The government also needs to ensure that the community knows the types of patients’ condition who can avail these services.Abstrak Implementasi Pelayanan Perawatan di Rumah (Home Care) oleh Puskesmas di Kota Makassar, Indonesia. Pelayanan perawatan di rumah (home care) oleh petugas kesehatan seperti dokter, perawat, dan petugas kesehatan lainnya bertujuan untuk memberikan pelayanan kesehatan meliputi pendidikan kesehatan, pengkajian fisik, atau memberikan terapi fisik ataupun pengobatan. Penelitian ini bertujuan untuk mengevaluasi kesesuaian antara implementasi pelaksanaan pelayanan home care di kota Makassar dengan petunjuk teknis pelaksanaan home care dari pemerintah. Penelitian ini adalah penelitian deskriptif kualitatif dengan melakukan wawancara mendalam kepada 15 orang perawat dari beberapa Puskesmas di kota Makassar, Indonesia, yang terlibat dalam kegiatan pelayanan home care minimal selama satu tahun. Terdapat empat tema utama yang ditemukan dalam penelitian ini antara lain, pengelolaan home care, peran perawat dalam pelaksanaan home care, hambatan dalam pelaksanaan home care, dan manfaat dari pelaksanaan home care di kota Makassar. Secara umum, pelaksanaan kegiatan home care sudah dilaksanakan sesuai petunjuk teknis dengan baik oleh perawat di Puskesmas kota Makassar walaupun masih ada beberapa hambatan dalam pelaksanaan kegiatan ini. Pemerintah diharapkan membuat petunjuk pelaksanaan (SOP) yang lebih jelas terkait pelaksanaan kegiatan ini atau melakukan pembaharuan regulasi terkait program ini. Kata Kunci: home care, peran perawat, puskesmas

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Lee, Dong-Wook, Sun Young Lee, Shin Hye Yoo, Kyae Hyung Kim, Min-Sun Kim, Jeongmi Shin, In-Young Hwang et al. „SupporTive Care At Home Research (STAHR) for patients with advanced cancer: Protocol for a cluster non-randomized controlled trial“. PLOS ONE 19, Nr. 5 (13.05.2024): e0302011. http://dx.doi.org/10.1371/journal.pone.0302011.

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Advancements in the treatment and management of patients with cancer have extended their survival period. To honor such patients’ desire to live in their own homes, home-based supportive care programs have become an important medical practice. This study aims to investigate the effects of a multidimensional and integrated home-based supportive care program on patients with advanced cancer. SupporTive Care At Home Research is a cluster non-randomized controlled trial for patients with advanced cancer. This study tests the effects of the home-based supportive care program we developed versus standard oncology care. The home-based supportive care program is based on a specialized home-based medical team approach that includes (1) initial assessment and education for patients and their family caregivers, (2) home visits by nurses, (3) biweekly regular check-ups/evaluation and management, (4) telephone communication via a daytime access line, and (5) monthly multidisciplinary team meetings. The primary outcome measure is unplanned hospitalization within 6 months following enrollment. Healthcare service use; quality of life; pain and symptom control; emotional status; satisfaction with services; end-of-life care; advance planning; family caregivers’ quality of life, care burden, and preparedness for caregiving; and medical expenses will be surveyed. We plan to recruit a total of 396 patients with advanced cancer from six institutions. Patients recruited from three institutions will constitute the intervention group, whereas those recruited from the other three institutions will comprise the control group.

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Afsha Awal Khan. „Skilled Nursing Facilities: The Missing Pillars of the Health Care System in Pakistan“. Journal of Farkhanda Institute of Nursing And Public Health (JFINPH) 2, Nr. 1 (28.06.2022): 1. http://dx.doi.org/10.37762/jfinph.48.

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The recent COVID-19 pandemic highlighted the loopholes in the health care system across the world. In developing countries, expenditure on health care is comparatively very low and the health care system is continuously under experiment, the concept of managed health care is still a dream.1 Burden is always in tertiary health care settings. In Pakistan, major teaching hospitals serve as primary and secondary healthcare facilities as primary healthcare centers are not fully functional. Consequently, tertiary hospitals always have a shortage of beds for acute conditions because it takes patients from one end and is not able to release patients at a similar rate.2 The major reason for this is a missing pillar called ‘skilled nursing facility or ‘nursing homes. A skilled nursing facility can accommodate patients who are in transition of care and do not require hospitalization as well as are not able to be shifted to homes safely. Therefore, governments should not only functionalize primary and secondary health services to decrease admissions rates in tertiary care hospitals3 but should also focus on the development of skilled nursing facilities and nursing homes. This will ease the transition of care from hospital to home, it will also decrease the length of stay and improve bed occupancy in acute care settings.4 According to the Pakistan Nursing Council (Amendment) Act, 2020, the scope of services for specialized nurses and Advanced Nurse Practitioners is extended to prescription with an advanced level of education and competence. Master qualified Nurses with advanced specialized patient management knowledge and skills can lead and run nursing homes or skilled nursing facilities. Evidence suggests that the contribution of nurses in advanced practice in specialized care settings not only increases the level of patient satisfaction with care and treatment, but it also decreases the average length of stay, and mortality rate.5 The cost of skilled nursing homes as compared to acute hospital beds is less than thirty per cent which means it may positively affect health care economics along with the provision of quality and safe care.6

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Kamphausen, Anne, Hanna Roese, Karin Oechsle, Malte Issleib, Christian Zöllner, Carsten Bokemeyer und Anneke Ullrich. „Challenges Faced by Prehospital Emergency Physicians Providing Emergency Care to Patients with Advanced Incurable Diseases“. Emergency Medicine International 2019 (26.11.2019): 1–11. http://dx.doi.org/10.1155/2019/3456471.

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Introduction. The aim of our study was to investigate challenges faced by emergency physicians (EPs) who provide prehospital emergency care to patients with advanced incurable diseases and family caregivers in their familiar home environment. Methods. Qualitative study using semistructured interviews with open-ended questions to collect data from 24 EPs. Data were analyzed using qualitative content analysis. Results. We identified nine categories of challenges: structural conditions of prehospital emergency care, medical documentation and orders, finding optimal patient-centered therapy, uncertainty about legal consequences, challenges at the individual (EP) level, challenges at the emergency team level, family caregiver’s emotions, coping and understanding of patient’s illness, patient’s wishes, coping and understanding of patient’s illness, and social, cultural, and religious background of patients and families. EPs strengthened that the integrations of specialized prehospital palliative care services improved emergency care by providing resources to patients and family caregivers, enhancing the quality and availability of medical documentation and accessibility of aftercare in emergencies. Areas of improvement that were identified were to promote emergency physicians’ knowledge and skills in palliative care, communication, and family caregiver support by education and training. Furthermore, structures for better care on-site, thorough medical documentation, and specialized palliative care emergency facilities in hospital and prehospital care were requested. Conclusion. Prehospital emergency care in patients with advanced incurable diseases in their familiar home environment may be improved by training EPs in palliative care, communication, and caregiver support competences. Results underline the importance of collaborative specialized palliative care and prehospital emergency care.

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&NA;, &NA;. „Oncology Education Services Launches Supportive Care Program“. Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 15, Nr. 12 (Dezember 1997): 885. http://dx.doi.org/10.1097/00004045-199712000-00019.

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Donovan, Leigh A., Penelope J. Slater, Angela M. Delaney, Sarah J. Baggio und Anthony R. Herbert. „Building capability in paediatric palliative care and enhancing education through the voice of parents: the Quality of Care Collaborative Australia“. Palliative Care and Social Practice 16 (Januar 2022): 263235242211288. http://dx.doi.org/10.1177/26323524221128835.

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Background: The greater proportion of children with a life-limiting condition (LLC) and their families want to remain at home as much as possible. Building capability in paediatric palliative care (PPC) for generalist health and social care professionals in nonmetropolitan regions through the Quality of Care Collaborative Australia (QuoCCA) has improved access to palliative care for families, regardless of where they live. Aim: To understand the experience of families whose child has received specialist PPC, to ensure future service capability development is informed by lived experience. Design: A retrospective, descriptive study in which parents participated in a semi-structured telephone interview guided by Discovery Interview methodology. Inductive thematic analysis identified the major learnings from participants. Participants: Parents caring for a child referred to the specialist PPC service, who received a pop-up visit and whose child is stable or who are more than 6 months bereaved. Results: Eleven parents ( n = 9 mothers; n = 2 fathers) of children with an LLC ( n = 5) or whose child had died ( n = 6) participated in an interview. The overarching themes and subthemes were as follows: (1) burden of suffering, in which parents described grieving for the life once anticipated, confronting many life transitions and seeking quality of life for their child and (2) umbrella of support, in which parents built partnerships with professional support, activated a network of care around their family and sought responses to their whole family’s needs. Conclusion: Parents caring for a child with an LLC described significant personal, familial, social and existential adjustments. This study integrates a relational learning approach with QuoCCA education grounded in the relationships between children, families and professionals. Learning from lived experience in PPC education enhances the preparedness of generalist health and social care professionals to join a child and their family throughout their various life transitions and facilitates the goal to remain at home within their community for as long as possible. Education in PPC is an imperative component of service models, enabling regional services to gain confidence and capability in the context of a dying child and their family, empowered and informed through the voice of the family. Plain Language Summary Enhancing palliative care for children through education informed by the experience of families It is often the wish of many children/young people with a life-limiting condition to stay at home with their families as much as possible. It is important that specialist palliative care services provide training and mentoring to the family’s local care professionals to support the delivery of good care, particularly those in rural and remote areas. This article aims to integrate the lived experience of families with palliative care education, so that the education reflects and addresses the needs that they express. Parents were interviewed by telephone using a method called Discovery Interviews. This is an open interview process, guided by a spine that describes the main points of palliative care. Parents can openly talk about their experience, focusing on the areas that are important to them. Interviews were studied by four researchers, and emerging themes were discussed and summarised. The study included parents whose child/young person was receiving support from specialist palliative care and bereaved parents whose child had died more than 6 months ago. In total, eleven parents (nine mothers and two fathers) were interviewed, five participants had children currently receiving palliative care and six were bereaved. The overarching themes were as follows: Burden of suffering, in which parents described grieving for the life they had expected, confronting transitions and seeking good quality of life for their child. Umbrella of support, in which parents built partnerships with care teams and activated a network of care to address the needs of their whole family. This study allowed the families’ perspectives to be integrated into the palliative care education of care professionals in the family’s local area. The lived experience of families prepared care professionals to support families with the care of their child/young person, allowing them to remain at home as long as possible.

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Juhrmann, Madeleine L., Andrea E. Grindrod und Caleb H. Gage. „Emergency medical services: the next linking asset for public health approaches to palliative care?“ Palliative Care and Social Practice 17 (Januar 2023): 263235242311631. http://dx.doi.org/10.1177/26323524231163195.

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Emergency medical services (EMS) are a unique workforce providing 24/7 emergency care across high-income countries (HICs) and low- and middle-income countries (LMICs). Although traditionally perceived as first responders to traumatic and medical emergencies, EMS scope of practice has evolved to respond to the changing needs of communities, including a growing demand for community-based palliative care. Public health provides a useful framework to conceptualise palliative and end-of-life care in community-based settings. However, countries lack public policy frameworks recognising the role EMS can play in initiating palliative approaches in the community, facilitating goals of care at end of life and transporting patients to preferred care settings. This article aims to explore the potential role of EMS in a public health palliative care approach in a critical discussion essay format by (1) discussing the utility of EMS within a public health palliative care approach, (2) identifying the current barriers preventing public health approaches to EMS palliative care provision and (3) outlining a way forward through priorities for future research, policy, education and practice. EMS facilitate equitable access, early provision, expert care and efficacious integration of community-based palliative care. However, numerous structural, cultural and practice barriers exist, appearing ubiquitous across both HICs and LMICs. A Public Health Palliative Care approach to EMS Framework highlights the opportunity for EMS to work as a linking asset to build capacity and capability to support palliative care in place; connect patients to health and community supports; integrate alternative pathways by engaging multidisciplinary teams of care; and reduce avoidable hospital admissions by facilitating home-based deaths. This article articulates a public health approach to EMS palliative and end-of-life care provision and offers a preliminary framework to illustrate the components of a potential implementation and policy strategy.

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Jaafar, Norrafizah, Komathi Perialathan, Mohamad Zaidan Zulkepli, Zaikiah Mohd Zin, Patricia Elisha Jonoi und Mohammad Zabri Johari. „Patients’ Perception Towards Health Education Services Received at the Enhanced Primary Healthcare Facilities: A Qualitative Exploration“. Journal of Primary Care & Community Health 11 (Januar 2020): 215013272098062. http://dx.doi.org/10.1177/2150132720980629.

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Background: The present Malaysian healthcare system is burdened with increasing cases of non-communicable diseases (NCDs) and its risk factors. Health care providers (HCPs) have to provide both treatment and health education to ensure optimal outcome. Health education is a vital component in addressing and managing chronic diseases. This study intends to explore patient’s perspective on health education services received from HCPs, focusing at the secondary triage in government primary healthcare facilities. Methods: This qualitative exploratory study focused on the health education component derived from a complex enhanced primary health care intervention. Participants were purposively selected from patients who attended regular NCD treatment at 8 primary healthcare facilities in rural and urban areas of Johor and Selangor. Data collection was conducted between April 2017 and April 2018. Individual semi-structured interviews were conducted on 4 to 5 patients at each intervention clinic. Interviews were transcribed verbatim, coded and analyzed using a thematic analysis approach. Results: A total of 35 patients participated. Through thematic analysis, 2 main themes emerged; Perceived Suitability and Preferred HCPs. Under Perceived Suitability theme, increased waiting time and unsuitable location emerged as sub-themes. Under Preferred HCPs, emerging sub-themes were professional credibility, continuity of care, message fatigue, and interpersonal relationship. There are both positive and adverse acceptances toward health education delivered by HCPs. It should be noted that acceptance level for health information received from doctors are much more positively accepted compared to other HCPs. Conclusion: Patients are willing to engage with health educators when their needs are addressed. Revision of current location, process and policy of health education delivery is needed to capture patients’ attention and increase awareness of healthy living with NCDs. HCPs should continuously enhance knowledge and skills, which are essential to improve development and progressively becoming the expert educator in their respective specialized field.

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Park, Y. S. „Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic“. Korean Journal of Women Health Nursing 5, Nr. 1 (28.03.1999): 106–18. http://dx.doi.org/10.4069/kjwhn.1999.5.1.106.

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The purposesof the study are to analyze the community nursing center in U.S.A. and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics; (2) institutional-based centers following the mission of a large institution, such as a hospital or university ; (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services; and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute care/illness management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs per agency and a median of three. Nursing centers availability varies : 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday-Friday. As the result of my visiting three health centers in seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the wellness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinical in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be revised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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Wilson, C. Ruth, James Appleyard, Juan E. Mezzich, Mohammed Abou-Saleh, Cal Gutkin, Chris Van Weel und Ted Epperly. „Challenges and Opportunities for Person Centered Integrated Care Through the Life Course“. International Journal of Person Centered Medicine 6, Nr. 2 (13.07.2016): 79–82. http://dx.doi.org/10.5750/ijpcm.v6i2.576.

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Objective: To examine the opportunities and challenges in achieving person centered integrated care through the life course. Methods: Critical literature review and evidence based analysis of person-centered integrated care through the life course, combined with expert consultation. The World Health Organization’s “Global Framework on Integrated People-Centred Health Services” is used as a basis. Results: Using the approach of the life cycle allows connection of persons’ current health status to their sociocultural, biological, and psychological context. Person centered medicine has as its central precept the relationship between the health professional and person seeking care. This principle is the link to primary health care, which is built on a lasting relationship with individuals and populations in their social context. The patient’s medical home provides one promising model of how health services can be organized to support the full achievement of person centered integrated care. Re-orientation of the health professional education towards generalism, and the development of metrics for measurement of person centered integrated care are required. In 2016 the global crisis in refugees is a particularly prominent challenge for the delivery of person centered integrated care. Conclusion: Universal health coverage can provide equitable access to person centered integrated care throughout the life course. Specialized expertise and skills are important for caring for persons with specific conditions at particular times in the life course. When care is well-integrated, transitions of care are smooth and the critical paradigm of person-centeredness is retained.

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V. M., Anantha Eashwar, Gopalakrishnan S. und Umadevi R. „Prevalence of hypertension and its association with psychosocial factors among old age home inmates in an urban area of Kancheepuram district, Tamil Nadu“. International Journal Of Community Medicine And Public Health 4, Nr. 10 (22.09.2017): 3712. http://dx.doi.org/10.18203/2394-6040.ijcmph20174238.

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Background: Among the non-communicable diseases prevalent among old age home inmates, hypertension is one of the diseases which if not diagnosed and treated adequately, could lead to high mortality and morbidity due to limited resources. The objective of this study is to find out the prevalence of hypertension among the old age home inmates and also its association with psychosocial morbidity among them. Methods: This community based cross sectional descriptive study was done among 250 inmates of selected old age homes in Kancheepuram district. A total of 8 old age homes were randomly chosen and universal sampling was done in each old age home to obtain the required sample size. Structured questionnaire was used to collect data and psychosocial morbidity among the inmates was assessed by Depression, Anxiety and Stress scale (DASS 21). Data analysis was done by SPSS software version 21. Results: The prevalence of hypertension and prehypertension was found to be 72.8% and 10% respectively and the prevalence of psychosocial morbidity was found to be high among the study participants (depression– 68.4, anxiety–46.8, stress– 50.4). Statistically significant association was found between uncontrolled hypertension and psychosocial factors (anxiety and stress). About 27% of the hypertensive was unaware of free medication offered for hypertension at Government health centres. Conclusions: This study highlights the need for setting up of specialized geriatric clinics at Government Health Centres to provide speedy medical services and supply of medication for the elderly. Health education has to be given to both the inmates and care takers about chronic diseases like hypertension.

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Rosqvist, Kristina, Marianne Kylberg, Charlotte Löfqvist, Anette Schrag, Per Odin und Susanne Iwarsson. „Perspectives on Care for Late-Stage Parkinson’s Disease“. Parkinson's Disease 2021 (15.03.2021): 1–11. http://dx.doi.org/10.1155/2021/9475026.

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In the late stage of Parkinson’s disease (PD), there is an increasing disease burden not only for the patients but also for their informal caregivers and the health and social services systems. The aim of this study was to explore experiences of late-stage PD patients’ and their informal caregivers’ satisfaction with care and support, in order to better understand how they perceive the treatment and care they receive. This qualitative substudy was part of the longitudinal European multicentre Care of Late Stage Parkinsonism (CLaSP) project. Individual semistructured interviews were conducted with patients (n = 11) and informal caregivers (n = 9) in Sweden. Data were analysed through the content analysis technique. The final analyses generated one main category: “We are trying to get by both with and without the formal care” and five subcategories: “Availability of health care is important for managing symptoms and everyday life”; “Dependence on others and scheduled days form everyday life”; “There is a wish to get adequate help when it is needed”; “Mixed feelings on future housing and respite care”; and “Family responsibility and loyalty for a functioning everyday life”. Having regular contact with PD-specialised health care was perceived as important. Greater access to physiotherapy was wished for. Maintaining autonomy was perceived as important by patients, in both home health care and a future residential care setting. Responsibility and loyalty between spouses and support from children enabled everyday life to carry on at home, indicating a vulnerability for those without an informal caregiver. The results suggest that regular access to PD-specialised health care is important and that a specialised and multidisciplinary approach to the management of PD symptomatology is likely necessary. Non-PD-specialised staff in home health care and residential care facilities should regularly be given opportunities to obtain PD-specific education and information.

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Chargualaf, Michael J., Tieumy T. Giao, Anna C. Abrahamson, David Steeb, Miranda Law, Jill Bates, Teshome Nedi und Benyam Muluneh. „Layered learning pharmacy practice model in Ethiopia“. Journal of Oncology Pharmacy Practice 25, Nr. 7 (07.01.2019): 1699–704. http://dx.doi.org/10.1177/1078155218820105.

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Purpose Ethiopia is home to a growing population of more than 100 million people. Healthcare in the region functions with a shortage of oncologists. Pharmacists as well as other healthcare providers can assist with expanding patient access to cancer care. A pilot project was proposed to provide education, determine areas to expand pharmacy services in oncology, and recommend interventions at Tikur Anbessa Specialized Hospital and Addis Ababa University. Methods A layered learning practice model comprising of a clinical pharmacist, a post-graduate year two oncology pharmacy resident, and two fourth-year student pharmacists was constructed for the experience. Through collaboration with the College of Pharmacy at Addis Ababa University, an international experience was developed to provide education and advance pharmacy practice at Tikur Anbessa Specialized Hospital. Results Based on findings from a needs assessment, the participants collaborated with key stakeholders to develop practices and procedures for the implementation of high-dose methotrexate and for comprehensive chemotherapy order review. In addition, 17 didactic lectures were provided to nine students enrolled in the Master of Pharmacy in Pharmacy Practice at the College of Pharmacy at Addis Ababa University. Conclusion This experience provided educational and clinical impact using a layered learning practice model, consisting of a clinical pharmacist, pharmacy resident, and pharmacy students in an international setting. There is significant potential for clinical pharmacy to positively impact patient care in the oncology setting in Ethiopia. Future initiatives for advancement include the safe handling of hazardous agents, additional therapeutic drug monitoring, and outpatient oncology pharmacist practice.

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Mitrea, Nicoleta, Daniela Moşoiu, Camelia Ancuţa, Pam Malloy und Liliana Rogozea. „The Impact of the End-of-Life Nursing Education Consortium International Training Program on the Clinical Practice of Eastern European Nurses Working in Specialized Palliative Care Services“. Journal of Hospice & Palliative Nursing 19, Nr. 5 (Oktober 2017): 424–34. http://dx.doi.org/10.1097/njh.0000000000000367.

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Jawed, Aysha, und Christine Peck. „Navigating the broken road: A call to strengthen access, equity, and inclusivity in the care of children with developmental disabilities and neurobehavioral disorders“. Health Promotion Perspectives 12, Nr. 4 (31.12.2022): 345–49. http://dx.doi.org/10.34172/hpp.2022.44.

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There is a significant scarcity of resources to achieve behavioral stabilization among children and adolescents with moderate to severe developmental disabilities and neurobehavioral disorders. In total, there are currently 76 inpatient pediatric neurobehavioral programs to support these patients across the United States. Many states do not currently have programs of this nature. Across existing programs, there are substantial waiting lists. In addition, non-public school, intensive day program, in-home and additional outpatient services are not reaching these patients fast enough which further exacerbate the sequalae of suboptimal outcomes and future quality of life implications for these patients. In addition, disparities remain in how the chronicity of developmental disabilities and neurobehavioral disorders are addressed within our healthcare system. It is crucial to categorize this constellation of specialized conditions as chronic illnesses which warrant continued care and treatment, similar in nature to lifelong medical conditions. Further time and priority are warranted in increasing accessibility, equity, and inclusivity in our U.S. healthcare system to optimize a range of health and developmental outcomes for these patients. Future work in this domain could also contribute towards the larger goal of the World Health Organization, Healthy People 2030, and the Sustainable Development Goals of the United Nations in securing delivery of healthcare services that are inclusive, equitable and accessible for individuals with disabilities.

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Holloway, Mark. „How is ABI assessed and responded to in non-specialist settings? Is specialist education required for all social care professionals?“ Social Care and Neurodisability 5, Nr. 4 (04.11.2014): 201–13. http://dx.doi.org/10.1108/scn-12-2013-0043.

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Purpose – The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services. Design/methodology/approach – A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs. Findings – ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change. Practical implications – An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings. Originality/value –Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs.

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Whelan, Dawn, und Ciara Parthiban. „Integrated Oncology Nursing Service (IONS)“. International Journal of Integrated Care 23, S1 (28.12.2023): 408. http://dx.doi.org/10.5334/ijic.icic23495.

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In recent years, the clinical context for cancer has changed and it is now characterized by extended survival rates and complex cancer trajectories and symptomatology.The changes in landscape of cancer care have included a shift towards the home setting or the outpatient setting with an increase in the amount of care being delivered at home or transferred to the patient/family themselves. According to the literature, societies are confronted with an increasing burden of health care as a result of an ageing population, the growing number of chronic diseases and coronavirus have forced governments and health care to seek new models in order to organize health care cost-effectively, without losing the current quality of care.Multi-professional and multi-agency interventions are now needed compared to when single specialities used to suffice.We need holistic care delivered in partnership to individuals, by flexible person-centred approaches. The Acute Oncology and Community Services have come together to collaborate to provide supportive care to vulnerable cancer patients in the community. The objective of this Integrated Oncology Nursing Service (IONS) role is to refer cancer patients to Community Intervention Team (CIT), post a specialised oncology telephone triage by the Acute Oncology Clinical Nurse Specialist (AO CNSp), to further assess/treat patients in the community. The CIT will provide services such as clinical vitals, phlebotomy, medication administration and psychological support to patients in their home. The AO CNSp. will then link in with the patient at home the next day and continue to consult with the oncology/haematology team to discuss the best way to manage the patient at home. We aim to bring together these separate organisations and place an emphasis on the shared values of timely, efficient and person-centered care. The benefit of this innovation is hoped to •Reduce unscheduled presentations and result in admission avoidance for patients accessing the Tallaght Hospital Oncology Services. •Improve the quality of patients treatment •Bring specialist knowledge to patients •Provides support to patients in their own home •Provide outreach to unwell patients at home The network governance model including nursing and clinical governance is shared by the Director of Public Health Nursing, the Director of Nursing of Tallaght University Hospital and the Oncology and Haemtology Consultants in Tallaght University Hospital. We will roll out education and training with competencies before commencing the pilot. There will be a dual approach to the evaluation of this initiative focusing on organisational impact and patient outcomes and experiences. A service evaluation has been completed already. A qualitative approach will be utilised to determine the patient’s experience and ethical considerations will be incorporated into the rolling out of the service. In conclusion, modern cancer care is mainly delivered on an outpatient basis, meaning that there are many people in the community at risk of side effects of treatment or manifestations of progressive disease that can present as emergencies. This is where the Integrated Oncology Nursing Service is most valuable, providing outreach to acutely unwell patients at home and bringing specialist knowledge to their management.

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Geddie, Patricia I., und Victoria W. Loerzel. „Adult Cancer Patients’ Perceptions of Factors That Influence Hospital Admissions“. Clinical Nurse Specialist 38, Nr. 3 (Mai 2024): 122–30. http://dx.doi.org/10.1097/nur.0000000000000816.

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Purpose/Aims To explore cancer patients’ perceptions of factors that influence hospital readmissions. Design A cross-sectional, prospective design was employed utilizing a 1-time survey and brief interviews to measure patients’ perceptions and unplanned hospital admissions. Methods and Variables The principal investigator collected data from medical record review, the Hospital Admission Survey, and interviews to measure patient characteristics and perceptions of influencing factors that contributed to an unplanned hospital admission upon admission. Data were analyzed using descriptive statistics to categorize patient perceptions of influencing factors of unplanned hospital admissions. Results The top reasons for admission were symptoms of uncontrolled gastrointestinal, pain, fever, and respiratory problems. The majority perceived the admission was unavoidable and wanted to avoid an admission. Perceived influencing factors were related to survey categories of 1) communication (ie, cannot reach physician anytime, cannot get a next-day appointment, medical problems are out of control, advised to go to the emergency department) and 2) home environment (ie, unable to adequately manage symptoms at home and hospital admission is the best place for care). Other survey categories of patient education and palliative care were not perceived as influencing or contributing factors. Conclusions These findings highlight opportunities for clinical nurse specialists to target these vulnerable patients and provide expert consultation to address potential barriers and gaps in utilization of appropriate supportive services that may reduce unplanned hospital admissions.

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Pais, V., O. Pinto, J. Figueiredo, E. Larez, F. Lopes, M. Pereira, M. Fernandez und S. Mariano. „Building A Psychosocial Rehabilitation Unit: The Experience of Centro Hospitalar Entre Douro e Vouga“. European Psychiatry 41, S1 (April 2017): s791. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1517.

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IntroductionIn Portugal, the National Mental Health Plan sought to reform the mental health care system, decentralizing mental health care by promoting community based services. Guidelines point to treatment of Psychotic Disorders with collaborative, person directed and individualized approaches.ObjectiveThe authors propose to describe the development of a new psychosocial rehabilitation unit in a recently created psychiatric department.MethodsThe CHEDV's psychiatry department (2009) serves a population of around 340,000. The Psychosocial Rehabilitation Unit (2015) aims to ensure a multidisciplinary and integrated response to users with major psychiatric disorders. The Psychosocial Rehabilitation Unit structures 4 axes of response: detection and initial approach of the disease, intervention in crisis, psychosocial rehabilitation and management of difficult patients.ResultsCHEDV's psychosocial rehabilitation unit is responsible for the care of about 25 patients daily. Treatment activities range from specialized consultations, home visits, medication management and crisis telephone to social skills training, psycho-education, neurocognitive rehabilitation, occupational workshops and social intervention/orientation. The unit bases its work on constant communication within the team but also with all other carers of the patient (in or out of hospital).ConclusionsBringing to the population a set of previously unavailable responses is the most blatant success of this unit that is helping people getting a better and closer care. To improve our work we aim at integrating the quantitative and qualitative psychometric evaluation of the patients. The lack of resources, necessity of further training, insufficient funding, and low political priority remain as the main barriers to community based mental health care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Moureau, Nancy L., und Ann Zonderman. „Complications of Vascular Access Device Terminal Tip Placement: A Case Study and Review of Subsequent Legal Action“. Journal of the Association for Vascular Access 12, Nr. 1 (01.03.2007): 33–37. http://dx.doi.org/10.2309/java.12-1-9.

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Abstract A patient experienced complications following insertion and use of 2 similar vascular access devices with tip termination apparently in the subclavian veins. The thrombotic complications that developed were identified and reported in the first incident (a) as an occluded catheter, and then (b) as bleeding complications with delayed reporting for 8 days with the second catheter. The result was symptomatic deep vein thrombosis, thoracic outlet syndrome, and permanent nerve damage in both right and left extremities used for the venous catheter. The patient brought charges of malpractice against the hospital, the home care company, one nurse, and the manufacturer, alleging permanent nerve damage, venous occlusion, and chronic pain syndromes associated with both upper extremities. During the subsequent trial, evidence of permanent loss of function to the patient's left arm and chronic pain to both arms was presented through documentation of loss of fitness and inability to perform actions necessary to his chosen career as a pilot. The pain and loss of function were directly related to terminal tip placement of the catheter and care provided in conjunction with the venous catheter. The jury trial awarded the patient a final judgment of $7.15 million, with the hospital 55% liable and 45% liability among the other defendants. The jury also added some hospital physicians to the liability of the treatment and resulting patient harm. Nurses caring for patients have a duty to assess and evaluate the patient for complications on an ongoing basis, administer the prescribed therapy, and consistently provide communication with the primary physician specific to the assessment findings. A specialized nurse or certified intravenous nurse (CRNI) is held to a higher level of knowledge, understanding, and function. In this case, a CRNI was providing care for the patient both through hospital and outpatient home care services. Medical professionals and hospitals can reduce the likelihood of liability related to adverse events with venous catheters by acquisition of current education on the devices they insert and maintain; by updating and adhering to policies and procedures based on Standards of Practice and manufacturer instructions for use; by thorough documentation of care; and by conscientious reporting of patient clinical signs and symptoms. The goal of achieving safe patient care with vascular access devices is only possible through consistent education processes with all associated clinical staff.

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Pluta, Agnieszka, Alicja Marzec, Edyta Kobus und Beata Sulikowska. „Main Aspects of Preparing Diabetic Patients in Poland for Self-Care“. International Journal of Environmental Research and Public Health 19, Nr. 18 (09.09.2022): 11365. http://dx.doi.org/10.3390/ijerph191811365.

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Diabetes is a lifestyle disease which can cause many complications and organ-related disorders. The aim of the study was to analyze selected aspects of preparing patients with diabetes for self-care. The study group consisted of 190 people diagnosed with type 1 and type 2 diabetes, including 101 women and 89 men. The mean age of the respondents was 42.2 ± 13.4 years. The study was conducted using an anonymous self-designed questionnaire containing 50 questions. Among the respondents, 23.2% did not control their glucose levels at home. The respondents most often measured glucose once a day (33.6%) or three times a day (26.7%). A total of 64.7% of the respondents declared that they kept a self-monitoring diary. The knowledge of the symptoms of hypoglycemia and the ability to properly manage it was declared by 64.8% of the respondents. A total of 52.1% of the patients did not undertake any activity lasting more than 30 min at least 3 times a week, and 75.2% described their condition as very good and good. Independent participation in therapy, i.e., taking hypoglycemic drugs or insulin, was declared by 63.7% of the respondents. Despite undergoing therapeutic education, the study population diagnosed with diabetes still shows deficiencies in terms of awareness of proper health behaviors. Objective results showed that the patients had insufficient knowledge and skills in terms of self-care and self-observation, blood glucose and blood pressure measurements, physical activity, diet therapy as well as adherence to pharmacotherapy recommendations. Despite the good general preparation for self-care as declared by the respondents, these patients require further systematic, individual educational activities. The results of the present study have implications for nursing practice, patient therapeutic education, and the functioning of the public health and healthcare systems. The number of diabetic patients is constantly increasing. Patients require coordinated care and individualized therapeutic education in order to be prepared for self-care and self-management, thus reducing the risk of complications. Delaying the occurrence of potential complications provides patients with a chance to live an active private and professional life, and protects the health care system from carrying the cost burden of expensive highly specialized services.

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Bogusława Urbaniak. „Social security and safety of older adults in Poland“. Magyar Gerontológia 12 (26.11.2020): 9–11. http://dx.doi.org/10.47225/mg/12/kulonszam/8450.

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Poland’ population will be ageing at a fast rate in the coming decades. It is projected that in 2070 the Polish ratio between people aged 65 and over and those aged 15-64 years will be 62.6, the highest among EU-27 countries. Population ageing appeared in the public debate in Poland as a separate subject in the 1990s, following a negative natural population increase and the looming impact of the massive withdrawal of baby boomers from the labour market on the pension system. One of the reasons for older persons’ growing interest in retirement was pension system reforms planned by successive governments. The announcement of the year 2012 as the European Year for Active Ageing and Solidarity Between Generations (decision no. 940/2011/EU of the European Parliament and of the Council of 14 September 2011) contributed in Poland to the emergence of a senior policy from a social policy and initiated major legislative, institutional, and organisational changes at the national, regional and local levels of government. It also inspired the redefinition of measures used hitherto in line with the evolution in the perception of older people from social care recipients to active members of their communities entitled to education and economic, social, civic and political activity. In 2013, the Senior Policy Council was established as a consultative and advisory body to the Ministry of Labour and Social Policy, and then similar councils supporting regional and local authorities were organised. In order to encourage greater activity among seniors, a special governmental programme was created in December 2013, which grants funds on a competitive basis to projects concerning social activities, education, and intergenerational cooperation submitted by informal and formal groups of seniors. The national government’s key documents on senior policy, one for the period from 2014 to 2020 and the other spanning the years until 2030, are Resolution 238 of 24 Dec. 2013 by the Board of Ministers on the Adoption of Long-term Senior Policy in Poland for the Years 2015-2020 and Resolution 161 of 28 Oct. 2018 by the Board of Ministers on the adoption of Social Policy Towards the Older Persons 2030. Security-Participation-Solidarity. In 2015, the Polish Parliament passed the elderly people act, which requires institutions in charge of the well-being of older persons to monitor and report on their situation. The reports submitted by the institutions are used by the Ministry of Labour to compile and present an annual evaluation of the status of the older population in Poland. The regional governments’ senior policy is reflected in their social policy strategies. The strategies’ operational goals started to address needs specific to older people since 2002, focusing in particular on improving their quality of life, developing round-the-clock care services, at-home care services, and rehabilitation services, and on reducing social exclusion and marginalization of seniors. Social security and the safety of older adults are progressively improving in Poland, but the greatest progress has been made in the area of active ageing. Social care services for the elderly still require improvement, because the predominant family care model is inefficient in many ways due to: limited financing of care services by public institutions, the growing proportion of single elderly persons, the increasing number of people aged 85+ (the so-called double population ageing), social insurance disregarding long-term care to an elderly family member as an insurable risk, a lack of legislation allowing employed people to seek a long-term leave to give care to an older family member, the informal expectation that women who retire at the age of 60 years will take care of the oldest family members. While neither the scale nor the quality of home care services given to older persons is regularly surveyed in Poland, it can be presumed that the scale of care services is insufficient and that they excessively burden families with a member in need of care. Between 2010 and 2018, the number of persons aged 65+ increased in Poland by over 1.5 million, the number of the users of attendance services and specialised attendance services by 29,000 (from 99,000 to 128,000), and the number of residences in homes and facilities providing assistance to aged persons by 7,000 (from 20,000 to 27,100.)

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Swinnen, Katja, und Leia Vrancken. „Enhancing transmural continuity of care for vulnerable patients with kidney problems. A mixed-methods multi-stakeholder needs-assessment“. International Journal of Integrated Care 23, S1 (28.12.2023): 130. http://dx.doi.org/10.5334/ijic.icic23051.

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Summary: Research on supporting the (in)formal caregiver, in enabling autonomy and empowering of persons with a chronic kidney disorder and creating a bridge between primary care and specialized care in hospital settings. Background: Almost half (48%) of hospital readmissions is due to a lack of continuity of care ,e.g. no discharge conversation, poor communication at discharge, lack of patient education and no patient empowerment, a lack of information flow between the hospital setting and primary care, … Especially vulnerable patients with e.g. low health literacy suffer from a not optimally organized transition from the hospital setting to home. More attention is needed for: patient and informal care giver engagement and education, person-centered support, coordination of the transmural care process in order to deliver continuous and responsible care. Target group: Vulnerable patients with kidney problems in the province of Flemish Brabant (Belgium). Involved and engaged stakeholders: Patients, informal care givers, hospital kidney department (doctors, nurses, physiotherapists, social workers, …), primary care professionals (GPs, nurses, physiotherapists, social workers, …). Intervention: A needs-assessment is performed regarding the continuity of care of vulnerable patients with kidney problems. Patients, informal care givers, primary care as well as hospital professionals are surveyed and interviewed. Results: Preliminary results show the need for optimized transmural care from the patient, informal caregiver and professional perspectives. Continuity of care is mainly lacking regarding its informational and therapeutic dimensions. The minimal or even absent information flow (informational continuity) results in therapeutic differences between the services offered by hospital and primary care professionals (therapeutic continuity). Special attention is needed for patient education and empowerment. Relational continuity between the patient and professionals is more fixed, but professionals often do not have fixed partnerships with each other, both within primary care as well as across the primary and hospital care settings. Lessons for international audience: - A multi-perspective needs-assessment uncovers the, sometimes hidden, needs with regard to continuity of care. - Transmural care is often still quite discontinuous, especially from the perspective of the vulnerable patient, informal care giver and primary care professional. - System-wide change is needed in terms of vision, goals, adapting to local health needs, using people as partners, redefining professional responsibilities and (re)training care professionals, and reconfiguring care delivery. Next steps: The information gathered through the needs-assessment is used to co-develop a continuity-enhancing intervention that optimizes the transmural care process with relevant stakeholders (patients and informal care givers or their representatives, primary care professionals, hospital professionals). The intervention is implemented and evaluated through a patient and professionals questionnaire and interviews.

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Strózik, Mateusz, Hanna Wiciak, Lukasz Szarpak, Pawel Wroblewski und Jacek Smereka. „EMS Interventions during Planned Out-of-Hospital Births with a Midwife: A Retrospective Analysis over Four Years in the Polish Population“. Journal of Clinical Medicine 12, Nr. 24 (15.12.2023): 7719. http://dx.doi.org/10.3390/jcm12247719.

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Planned out-of-hospital births, facilitated by highly skilled and experienced midwives, offer expectant parents a distinct opportunity to partake in a personalized, intimate, and empowering birth experience. Many parents opt for the care provided by midwives who specialize in supporting home births. This retrospective study is based on 41,335 EMS emergency calls to women in advanced pregnancy, of which 209 concerned home birth situations documenting obstetrical emergencies over four years (January 2018 to December 2022), of which 60 involved the assistance of a midwife. Data were obtained from the Polish Central System for Emergency Medical Services Missions Monitoring, encompassing all EMS interventions in pregnant women. The most frequent reason for emergency calls for obstetrical emergencies with the assistance of a midwife was a failure to separate the placenta or incomplete afterbirth (18 cases; 30%), followed by perinatal haemorrhage (12 cases; 20%) and deterioration of the newborn’s condition (8 cases; 13%). Paramedic-staffed EMS teams conducted most interventions (43 cases; 72%), with only 17 (28%) involving the presence of a physician. Paramedics with extensive medical training and the ability to provide emergency care are in a unique position that allows them to play a pivotal role in supporting planned out-of-hospital births. The analysed data from 2018–2022 show that EMS deliveries in Poland are infrequent and typically uncomplicated. Continuing education, training, and adequate funding are required to ensure the EMS is ready to provide the best care. EMS medical records forms should be adapted to the specific aspects of care for pregnant patients and newborns.

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Paraska, Karen. „Relationship Between Expanded Health Belief Model Variables and Mammography Screening Adherence in Women with Multiple Sclerosis“. International Journal of MS Care 14, Nr. 3 (01.10.2012): 142–47. http://dx.doi.org/10.7224/1537-2073-14.3.142.

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People with disabilities often find it more difficult to access health-care services than the general population, further jeopardizing their health and well-being. The purpose of this descriptive pilot study was to explore the relationship between variables of the Expanded Health Belief Model (EHBM) and adherence to mammography screening in a sample of homebound women with MS after completion of a National Multiple Sclerosis Society (NMSS) intervention, known as the “Home-Based Health Maintenance Program for Women with MS,” that was conducted in Allegheny County, Pennsylvania. The intervention was conducted in the patients' homes and included education of the women and their partners on risk factors for breast cancer and instruction in breast examination techniques. The patients were also helped to make appointments for mammograms. This study derived its sample from the intervention program and used data on adherence recorded by the NMSS. After completion of the intervention, telephone interviews were conducted with women who met the inclusion criteria (N = 11). Descriptive statistics indicate that adherence can be successfully described using variables of the EHBM, including perceived susceptibility, perceived severity, perceived benefits, and self-efficacy. The instruments chosen for the research were well tolerated, useful, and efficient to administer and allowed for immediate assessment.

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Payne, Jackelyn B., Lillian Chen, Cathy D. Ho, Kaylin V. Dance, Andrew Ritter und Christopher R. Flowers. „Priorities for Rural Lymphoma Survivors: An Exploratory Study“. Blood 132, Supplement 1 (29.11.2018): 4789. http://dx.doi.org/10.1182/blood-2018-99-117642.

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Abstract Background: Rural cancer patients, including those with lymphoma, have unique needs and barriers to care, including access to preventive and specialized care, economic resources, and proximity to supportive services. Research is needed to thoroughly understand these needs and propose solutions to health outcome disparities in these populations. Objective: We conducted a qualitative study with lymphoma survivors living in rural areas to: 1) determine perceived unmet needs regarding lymphoma care in rural areas and 2) examine views, understanding, and priorities for rural patients' participation in and education about therapeutic and non-therapeutic clinical research studies. Methods: We conducted 11 individual semi-structured phone interviews in the spring of 2018 with lymphoma survivors living in rural counties in the state of Georgia. Patients were identified by a home address in counties classified as rural based on Rural/Urban Commuting Areas (RUCAs), a categorization system used in the research community to classify rural and urban areas based on census track level data. Individual interview participants were recruited from regional patient education conferences and among current research participants at a university research hospital in the state of Georgia. Interviews were recorded and transcribed verbatim. Thematic analysis was used to identify themes emerging from these data. MAXQDA 18.0.8 qualitative data analysis software was utilized to facilitate a constant-comparative coding process to identify the resulting themes. Results: The greatest barrier to care expressed by the participants was distance. Interviewees had to frequently take time off of work and travel any time they needed to see a specialist or visit a cancer center in a larger city, often requiring several hours of travel by car. Many participants felt they were burdening their family and friends by relying on them for transportation. Rural lymphoma patients and caregivers described difficulty navigating between their local clinics and the larger cancer centers. Distance also was a barrier to attending educational events or support groups. Many participants were frustrated with their diagnosis experience at small clinics and regretted that they didn't seek the opinion of a specialist sooner. Some also felt that the team at their local clinic was not as knowledgeable about their treatment plan or its long-term effects. Although smaller, local clinics facilitated building relationships with the team and provider, there were drawbacks to relying on a local clinic, including lack of specialized providers and opportunities to participate in research. Communication between local and specialized clinics complicated the process, and participants had more difficulty contacting or seeking advice from the team at larger cancer centers. However, electing to receive treatment from specialized clinics farther away also had consequences. One solution agreed upon by nearly all of the participants was the use of technology to communicate. Participants were extremely supportive of online patient portals available at larger cancer centers which allowed them to more easily communicate with their clinical care team and helped them feel involved with their care, while educational or informative smartphone applications allowed them to access and streamline information that otherwise was not available in a rural area. Conclusion: These findings suggest that targeted research and interventions are necessary to address the specific needs of rural lymphoma survivors. To address the disparity in health outcomes that exists in this population, health care professionals and investigators can utilize these data to engage rural survivors in their treatment decision-making. In particular, the preference in this study population for using technological innovation to communicate contributes to the body of research regarding the significance technology has and can continue to have in lymphoma care. Disclosures Flowers: TG Therapeutics: Research Funding; Pharmacyclics: Research Funding; Denovo Biopharma: Consultancy; Gilead: Research Funding; Abbvie: Research Funding; Spectrum: Consultancy; Janssen Pharmaceutical: Research Funding; Burroughs Wellcome Fund: Research Funding; Karyopharm: Consultancy; Genentech/Roche: Consultancy; Bayer: Consultancy; Genentech/Roche: Research Funding; Millennium/Takeda: Research Funding; OptumRx: Consultancy; Celgene: Research Funding; Eastern Cooperative Oncology Group: Research Funding; Abbvie: Consultancy, Research Funding; BeiGene: Research Funding; Acerta: Research Funding; Pharmacyclics/ Janssen: Consultancy; Gilead: Consultancy; National Cancer Institute: Research Funding; V Foundation: Research Funding.

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Kotschan, N. „Advances in Screening and Early Detection“. Journal of Global Oncology 4, Supplement 2 (01.10.2018): 147s. http://dx.doi.org/10.1200/jgo.18.87000.

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Background and context: Although breast, cervical and prostate cancer screening are provided to communities in support of the Early Detection Saves Lives campaign in South Africa, it is crucial to collaborate with other health partners for services such as HIV/AIDS, tuberculosis, social services and screening for noncommunicable diseases. This is due to the high prevalence of HIV/AIDS, tuberculosis and noncommunicable diseases in the country. HIV/AIDS-related cancers are rising with other diseases and this impacts on the patient's treatment, care and quality of life. Aim: The primary objective of the introduction of these health partners and other sectors (education, women in presidency, commission for gender equality, transport and home affairs) are to ensure that the patient receives holistic care and postscreening runs effectively where both patient and medical professional hold updated records. Strategy/Tactics: 1. We worked closely with respective Community-Based Primary Healthcare Centres (PHC) on corporate funded outreaches scheduled in five provinces of SA, using our mobile units for screening purposes. 2. Remote areas with reduced access to specialized healthcare services were specifically targeted. 3. Captured patient histories, identification, and treatment (pre- and postscreening) provided PinkDrive/MBTM with sufficient information to run streamlined screening processes. 4. Patients were first screened for HIV-AIDS, tuberculosis and thereafter screened for noncommunicable diseases, e.g., gender-related cancers and obesity. Outcomes: 1. In a collaborative structure, we have found that the patient is privy to understanding the level, importance and stage of cancer with other related illnesses. 2. Results are more controlled and the patient's health record is captured at the relevant health institutions. 3. Holistic healthcare services and medical treatments are monitored, measured and managed appropriately at the relevant healthcare institution. 4. A relatively high demand for Pap smear screening was noted at many PHCs as many were still utilizing outdated Pap smear kits. What was learned: Collaborative initiatives are good success stories incorporating best practices and also benefitting the patients and medical professional. We are living in a digital age and yet our equipment and machinery is not state of the art. The mobile truck, in many instances, has to travel to the most remote areas with poor road infrastructure. New technology will make a remarkable difference, especially if it is systemised to the relevant institution, upgraded, built-in with latest developments so that the mobile truck is able to travel on all road types. For South Africa, PinkDrive/MBTM have grown tremendously and are continuously building public private partnerships.

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Cenedesi Júnior, Mario Angelo, Dirce Pacheco Vitório Rodrigues, Maria Cecília Merege, Fernanda Santos Schwarz, Glaucia Sá Brandão Freitas Gomes, Jocilane Lima de Almeida Vasconcelos, Juciane Lima do Nascimento Melo et al. „The challenges in rebuilding a quality public health in Brazil“. OBSERVATÓRIO DE LA ECONOMÍA LATINOAMERICANA 22, Nr. 2 (15.02.2024): e3219. http://dx.doi.org/10.55905/oelv22n2-088.

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In recent years, Brazil has grappled with a denialist approach to its healthcare system, the Unified Health System (SUS), especially during the COVID-19 pandemic. Influential figures, including public personalities, have cast doubt on science, leading to widespread uncertainty. Despite the challenges, Brazil boasts a strong National Immunization Plan (PNI) that has served as a global reference. The country faces the demographic transition, with an aging population requiring healthcare adaptation. Addressing chronic diseases becomes paramount, as does managing the economic implications of an older workforce supporting retirees. Inequalities in access to quality public healthcare persist due to socioeconomic disparities, a divided healthcare system, geographic disparities, ethnic and racial inequalities, education and cultural factors, and long wait times in the public healthcare system. Environmental issues, like deforestation, wildfires, climate change, water pollution, pesticide use, industrial pollution, and food security, impact public health. Sustainable policies and awareness are crucial. Health research in Brazil thrives in universities, institutions, and through international collaboration. Clinical research, epidemiology, public health research, and tropical medicine research are prevalent, but funding challenges and research misconduct persist. Combating infodemia and fake news is essential to ensure that public health decisions are based on reliable information. Fact-checking organizations, healthcare professionals, and education play a vital role. Expanding vaccination coverage is critical to protect against infectious diseases. Brazil employs campaigns, vaccination centers, home visits, school vaccination, partnerships, effective communication, vaccination records, education, and prioritizing high-risk groups. Strengthening the First Level of Health Care through the Family Health Strategy, coverage expansion, professional qualification, electronic health records, prevention programs, management strategies, specialized care, service integration, and community participation can improve healthcare access and coordination. Health education in Brazil focuses on health promotion, disease prevention, child and family health, sexual education, community engagement, school education, information accessibility, and trust in public health policies. The growth of health technology in Brazil can enhance care quality, access, resource management, disease prevention, cost savings, and innovation. However, ethical considerations, equitable access, and data privacy are vital. A democratic environment in public health promotes community participation, accountability, equity, evidence-based decision-making, individual and collective rights, anti-corruption efforts, conflict resolution, and long-term policy planning. SUS funding faces challenges of insufficient resources, budget predictability, dependence on unstable funding sources, regional inequalities, healthcare professional shortages, underfunding of complex services, lack of prevention investment, corruption, and an aging population. Addressing these challenges is vital to maintain SUS as an equitable and effective healthcare system. In conclusion, addressing these healthcare challenges and opportunities is crucial for Brazil's future. It requires ongoing investment in public policies, a multidisciplinary approach, and active community participation. Strengthening primary healthcare and combating misinformation are essential steps toward a healthier and more equitable Brazil.

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Nwafo, Wandji, Marie-Louise Nwafo. „HOLISTIC APPROACH TO ASSISTING THE ELDERLY IN MANAGING THEIR DAILY LIVES“. Nigeria Journal of Home Economics (ISSN: 2782-8131) 10, Nr. 6 (30.06.2022): 7–12. http://dx.doi.org/10.61868/njhe.v10i6.83.

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The demographic weight of the elderly in sub-Saharan Africa, estimated at 5%, although low, is increasing year by year. In Cameroon, the socioeconomic situation of retirees is influenced by several factors: (1) individual characteristics (age category, marital status, activity status, education and literacy level, fertility status, health status); (2) the socio-cultural environment (habits and customs, attitudes and beliefs towards the elderly, negative behaviours towards the elderly -violence, ageism, etc.-(3) health care services (health programmes for the elderly - prevention and screening campaigns for diseases of old age -, geographical accessibility to health care, existence of specialised geriatric care facilities, etc.) (4) the family environment (the way the elderly live together -family, institution, alone-, the place of residence -urban, rural-, the status of the elderly person in the household; (5) socio-economic factors (the income of the elderly -pensions, survivors' pensions, income from work, family transfers, life annuities, etc.), the type of care provided, the type of care provided, the type of care provided, the type of care provided, the type of care provided, etc.).-, (6) the political, legal and institutional environment (the national policy for the elderly, the legal framework for the protection and promotion of the elderly, the administrative structures for the care of the elderly, the social security system). Home Economics counsellors can support the elderly by managing their daily lives in a holistic approach. To this end, at least four types of action are possible: (i) developing an individual database on the socio-economic situation of the elderly; (ii) improving the health of the elderly by organizing nutritional literacy campaigns (iii) improving the income of the elderly through training and advisory support in starting and managing an income-generating activity; (iv) initiating/participating in an advocacy campaign for the social protection of the elderly. The presentation presents some statistical data from the last census of the elderly in Cameroon in order to understand their socio-economic situation before proposing a model of support for retirees.

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Silva, Rosane Meire Munhak, Adriana Zilly, Luciana Mara Monti Fonseca und Débora Falleiros De Mello. „Elementos qualificadores do seguimento de prematuros no campo da atenção primária à saúde [Components of quality preterm follow-up in primary health care] [Elementos calificadores del seguimiento de prematuros en el ámbito de la atención primaria de salud]“. Revista Enfermagem UERJ 30, Nr. 1 (13.01.2023): 64966. http://dx.doi.org/10.12957/reuerj.2022.64966.

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Objetivo: analisar evidências científicas na literatura sobre os elementos qualificadores do seguimento de prematuros no âmbito da atenção primária à saúde. Método: revisão integrativa da literatura, com inclusão de 27 artigos científicos, publicados entre 2011 e 2020, nas bases de dados PubMed/Medline, Scielo, Cinahl e Web of Science. Resultados: os elementos que qualificam o seguimento à saúde de crianças prematuras referem-se ao planejamento da alta hospitalar, organização do plano de cuidados no domicílio, seguimento por visita domiciliar e teleatendimento, promoção da saúde e prevenção de agravos, integração entre serviços de saúde e educação, acompanhamento especializado de complicações e suporte parental. Conclusão: a revisão trouxe elementos disparadores e convergentes para a gestão dos cuidados primários em saúde. Tais elementos requerem um modo oportuno e eficiente na organização das ações, para um processo de crescimento e desenvolvimento profícuo, com impacto na mortalidade, nas re-hospitalizações, nas situações vulneráveis e na qualidade de vida.ABSTRACTObjective: to examine the scientific evidence in the literature on the qualifying elements of primary health care follow-up of premature infants. Method: this integrative literature review included 27 scientific articles published between 2011 and 2020 in the PubMed/Medline, Scielo, Cinahl and Web of Science databases. Results: the components of quality preterm follow-up on the health of premature children include hospital discharge planning, home care plan organization, follow-up through home visits and telecare, health promotion and disease prevention, integration between health and education services, specialized follow-up of complications, and parental support. Conclusion: the review brought out triggering and converging elements for primary health care management. These elements require timely and efficient organization of measures, in order for productive process of growth and development with impact on mortality, re-hospitalization, vulnerable situations, and quality of life.RESUMENObjetivo: analizar las evidencias científicas de la literatura sobre los elementos calificadores del seguimiento de prematuros en el ámbito de la atención primaria a la salud. Método: revisión integrativa de la literatura, con inclusión de 27 artículos científicos, publicados entre 2011 y 2020, en bases de datos PubMed/Medline, Scielo, Cinahl y Web of Science. Resultados: los elementos que califican el seguimiento de la salud de prematuros se refieren a la planificación del alta hospitalaria, organización del plan de cuidados en el domicilio, seguimiento por visita domiciliaria y remoto, promoción de la salud y prevención de lesiones, integración entre servicios de salud y educación, seguimiento especializado de complicaciones y apoyo parental. Conclusión: la revisión trajo elementos disparadores y convergentes a la gestión de los cuidados primarios en salud. Estos elementos requieren un modo oportuno y eficiente en la organización de las acciones, para un proceso de crecimiento y desarrollo profesional, con impacto en la mortalidad, en las internaciones repetidas, en las situaciones vulnerables y en la calidad de vida.

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Alekseeva, Lyubov V. „About Some Aspects of Public Health Care and Socio-Cultural Sphere of Yugra in Extreme Conditions of the War“. Bulletin of Nizhnevartovsk State University, Nr. 1 (15.03.2024): 62–83. http://dx.doi.org/10.36906/2311-4444/24-1/06.

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The subject of the article is the little-studied issues of the state of health care and socio-cultural sphere of Khanty-Mansiysk National District (1941–1945). The conditions and factors of changes are determined; the main tasks and their implementation in the studied spheres based on the introduction of new documents into the scientific circulation. In the center of attention is the analysis of the factors that influenced the financial, personnel, material support of the state institutions in the changed wartime conditions. The author reveals the existence of typical problems in the situation of health care, education and culture, ways of overcoming difficulties. Much attention in the article is paid to the analysis of facts showing the work of the health care system within the framework of the tasks defined by the People's Commissariat for Health of the USSR to protect the health of the population (children are in the first place), to prevent epidemics. In the state of school affairs, the discussion issues concerning the number of schools, the contingent of students at different levels of education, the problem of universal education coverage of children aged 8–15, the number and staffing of teachers are characterised. The material on staff training in the district's specialised secondary educational institutions is systematised, quantitative indicators and conditions of activity, teachers’ and students’ material and living conditions are analysed. The cultural sphere was financed on a residual principle, in fact, it deprived of the district centralised management, but made its best contribution to the solution of problems on cultural services to the population, being a transmitter of state-patriotic ideas. The author formulates the conclusion that health care, education and culture, despite the enormous difficulties of wartime, in general withstood the tests, fulfilled the assigned tasks, and as a very significant part of the home front, contributed to the victory in the hardest war of the Soviet people. Scientific novelty and practical significance of the presented materials are determined by the introduction of new archival documents into the scientific turnover, clarification and expansion of ideas about socio-cultural processes in the region, their theoretical understanding on the basis of modernisation paradigm and system approach. The obtained new knowledge, systematised and structured, can be applied both in scientific research and in the educational process, as well as in socio-cultural projects of the Khanty-Mansiysk Autonomous District. It is quite obvious that the interpretation of the history of Yugra during the war years as a rear area needs a significant expansion of the traditional topics and setting new research problems. It is necessary to pay attention to different aspects of life on the home front, including the social sphere. The complexity of the military era (including everyday life of different categories of people in the district: the main population, temporary (evacuees) and special contingent) requires the identification of peculiarities in their social, material and economic situation. There is a need to rethink the subjects related not only to the analysis of the effectiveness of the Party and state management structures in the spheres of health care, education and culture, but also to the legal situation, the real role of the ruling Communist Party, and in a broader context – to find out the key characteristics of the military-political regime and its relationship with society on the materials of the region.

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Khisa, Amos, Leonard Kisovi, Sifuna Maxwell und Francis Onsongo. „Social Cultural Factors Affecting Fertility Among Women Living with Disability in Bungoma County, Kenya“. East African Journal of Arts and Social Sciences 6, Nr. 1 (08.05.2023): 292–309. http://dx.doi.org/10.37284/eajass.6.1.1205.

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This research aimed to explore the childbearing gap created by sociocultural challenges among disabled women in Bungoma County. Using a pronatalist approach, the study explores the extent to which the level of education, marital status and social status influence fertility attainment among WLWD. The research was directed by planned behaviour theory by Icek Ajzen (1991), which helped analyse the interaction of childbearing motivations, decision-making processes and fertility outcomes. Cross-sectional design was adopted and participants aged between 15 to 49 years old were selected using purposeful sampling. A pre-tested structured questionnaire, key informant guide and two focus groups were adopted to gather data. A sample size of 120 comprised women living with disability, health officials, administrators, and family members. The study area was mapped out with nine sites selected in Bungoma Central and Kimilili sub-counties in Bungoma County. A pilot study was done in the Kimilili subcounty to test reliability. Descriptive data underwent content analysis, themes coded using the framework analysis approach and transcribed, while quantitative data underwent logistic regression analysis using the SPSS package. Chi-square tests were used to link associations between sociocultural factors and fertility outcomes among WLWD in Bungoma County. Data results were represented using tables of frequencies, charts, graphs and percentages. These cultural barriers were identified as stigma, cultural beliefs and cultural attitudes. The study concludes that lack of education, low social status, overwhelming stigma and conservative mode of the patriarchal family system negatively depresses the fertility outcomes of disabled women in Bungoma County. The research recommended that disabled people ought to be helped to get an education and promote programmes against cultural biases towards fertility. Further, special hospital or home care units with well-trained personnel by the government were recommended to give specialised services to the WLWD

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Arias-Casais, Natalia, Jesús López-Fidalgo, Eduardo Garralda, Juan José Pons, John Y. Rhee, Radbruch Lukas, Liliana de Lima und Carlos Centeno. „Trends analysis of specialized palliative care services in 51 countries of the WHO European region in the last 14 years“. Palliative Medicine 34, Nr. 8 (10.06.2020): 1044–56. http://dx.doi.org/10.1177/0269216320931341.

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Background: Service provision is a key domain to assess national-level palliative care development. Three editions of the European Association for Palliative Care (EAPC) Atlas of Palliative Care monitored the changes in service provision across Europe since 2005. Aim: To study European trends of specialized service provision at home care teams, hospital support teams, and inpatient palliative care services between 2005 and 2019. Design: Secondary analysis was conducted drawing from databases on the number of specialized services in 2005, 2012, and 2019. Ratios of services per 100,000 inhabitants and increase rates on number of services for three periods were calculated. Analysis of variance (ANOVA) analyses were conducted to determine significant changes and chi-square to identify countries accounting for the variance. Income-level and sub-regional ANOVA analysis were undertaken. Setting: 51 countries. Results: Forty-two countries (82%) increased the number of specialized services between 2005 and 2019 with changes for home care teams (104% increase-rate), inpatient services (82%), and hospital support teams (48%). High-income countries showed significant increase in all types of services ( p < 0.001), while low-to-middle-income countries showed significant increase only for inpatient services. Central–Eastern European countries showed significant improvement in home care teams and inpatient services, while Western countries showed significant improvement in hospital support and home care teams. Home care was the most prominent service in Western Europe. Conclusion: Specialized service provision increased throughout Europe, yet ratios per 100,000 inhabitants fell below the EAPC recommendations. Western Europe ratios’ achieved half of the suggested services, while Central–Eastern countries achieved only a fourth. High-income countries and Western European countries account for the major increase. Central–Eastern Europe and low-to-middle-income countries reported little increase on specialized service provision.

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Samuelson, Darlene. „Home Care Nursing Services“. Journal for Nurses in Staff Development (JNSD) 14, Nr. 3 (Mai 1998): 160. http://dx.doi.org/10.1097/00124645-199805000-00011.

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Markle-Reid, Maureen, Camille Orridge, Robin Weir, Gina Browne, Amiram Gafni, Mary Lewis, Marian Walsh et al. „Interprofessional Stroke Rehabilitation for Stroke Survivors Using Home Care“. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 38, Nr. 2 (März 2011): 317–34. http://dx.doi.org/10.1017/s0317167100011537.

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Objective:To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.Methods:Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.Results:A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p = 0.76).Conclusions:A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229

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Northwood, Melissa, Jenny Ploeg, Maureen Markle-Reid und Diana Sherifali. „Understanding the Complexity of Diabetes and Urinary Incontinence in Older Adults Receiving Home Care Services: Protocol for a Mixed Methods Study“. International Journal of Qualitative Methods 18 (01.01.2019): 160940691985200. http://dx.doi.org/10.1177/1609406919852000.

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Urinary incontinence (UI) is a very prevalent problem for older adults with type 2 diabetes mellitus (T2DM) receiving home care services. However, the complexities of living with UI and T2DM and providing nursing care for older adults in the home care context have received very little research attention. This article describes a protocol for a convergent, mixed methods research design study to address this knowledge and practice gap. The objectives of the proposed study are to (a) determine the prevalence and correlates of UI in older adults living with T2DM receiving home care services, (b) explore the experiences of older adults living with T2DM and UI receiving home care services, (c) explore the experiences of home care nurses caring for this population, and (d) converge the multiple data sources to provide a deeper understanding of the problem and implications for provision of home care services to this population. The research methods are informed by a model of clinical complexity. The quantitative strand will involve descriptive and inferential analysis of standardized home care assessment data (interRAI) to determine the prevalence and correlates of UI in older adults with T2DM receiving home care services. Interpretive description methods will be used in the qualitative strand, and interviews will be conducted with older adults and home care nurses. The findings will be converged to inform a better understanding of the complexity of living with these chronic conditions for older adults receiving home care services and generate implications for complex intervention development. This protocol highlights methodological insights in utilizing mixed methods research to inform intervention design.

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Papke, Jens Hermann. „Provision of specialized palliative care in a multiprofessional network.“ Journal of Clinical Oncology 32, Nr. 31_suppl (01.11.2014): 144. http://dx.doi.org/10.1200/jco.2014.32.31_suppl.144.

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144 Background: In Germany specialised palliative care in outpatient setting is financed by health insurances since 2007. Home Care Sachsen e.V. is a specialised palliative care provider working with two palliative care teams including qualified nurses, physicians and social workers in closely cooperation with general practitioners and nursing services. We report about the results of our work in a rural area around Dresden in Saxony, Germany. Methods: Our data were collected prospectively with PalliDoc software. Results: Between 2011 – 2013 Home Care Sachsen e.V. served for 1,572 pts (888 m, 684 f); 93% with an oncologic disease. Median age was 71 y, Karnofsky index was 40%, median caring time 27 days. In this time, 25% of our pts had one stay in hospital, 8% two and 4% three and more. 63% had no stays in hospital. At least 1,271 pts. died: 65% at home; 9% in nursing homes and hospices; 15% in palliative care units and 11% in hospital. Conclusions: Mean home death rate of oncologic pts without intervention in Germany is about 44% (Papke J, Koch R: Places of Death from Cancer in a Rural Location. Onkologie (2007) 30, 105-08). This proportion could be enhanced considerably with outpatient palliative care. Providing of specialised palliative care with a multiprofessional team is effective to increase the rate of dying at home and to fulfill one of the strongest wishes of pts in a palliative situation.

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Nova, Amanda, Navjot Gill, Amy Miles, George Heckman, John Hirdes, Andrew Costa und Paul Hérbert. „Referral of community-dwelling older adults from eight emergency departments in Canada: A secondary analysis of cross-sectional data from the interRAI multinational emergency department (ED) cohort study“. International Journal of Integrated Care 23, S1 (28.12.2023): 59. http://dx.doi.org/10.5334/ijic.icic23331.

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Background: Emergency Department (ED) overcrowding, unnecessary hospitalization, and alternate level of care has been identified as a major issue in Canada and around the world. This problem especially impacts older adult populations, who are at elevated risk of functional decline and adverse events in hospital-centric systems. This study uses data from the interRAI ED Contact Assessment (ED-CA)[1], a comprehensive geriatric assessment used in the ED, to improve our understanding of ED systems of referral to community resources. Target Audience: ED staff in clinical and leadership positions interested in better understanding community referral processes to improve care for community-dwelling older adults. Methods: This study is a secondary analysis of cross-sectional Canadian data from a cohort study of elderly ED patients. The cohort of community-dwelling patients aged 65 and older presented to the ED between April 2017 and July 2018. They were screened and recruited in 10 EDs across Ontario, Quebec, and Newfoundland. The data were analyzed using frequency and logistic regression analyses, then the results were interpreted in collaboration with two geriatricians and one physiotherapist. What was done: This study explored referral patterns and identified predictors of referral from the ED to five different community health services (occupational therapy, physiotherapy, home care, social work, and/or specialized geriatric services) for supporting community-dwelling older adults. Results: We found that the sample (n=1055) was frail, with high needs and a high risk of ED revisit and institutionalization. Over half of the sample was referred to home care, occupational therapy, and/or physiotherapy, while only 16% were referred to specialized geriatric services. Most patients received multiple referrals from the ED. Province was the most impactful predictor for referral to occupational therapy or physiotherapy (OR for Ontario vs. Quebec=62.12, 95% CI [19.04, 202.70]) and home care (OR for Ontario vs. Quebec=12.09, 95% CI [5.81, 25.17]), while having an unstable condition was the most impactful predictor for social work referral (OR=5.51, 95% CI [3.78, 8.02]) and weight loss was the most impactful predictor for specialized geriatric service referral (OR=8.13, 95% CI [5.49, 12.04]). Other notable predictors included having overwhelmed family members, self-rated health, and having had a fall in the last 90 days. Key Learnings: Occupational therapy, physiotherapy, home care, social work, and specialized geriatric services are distinct services, specialized in addressing a specific set of care needs. We learned that specialized geriatric services are underutilized and may be poorly understood. Next Steps: To improve the quality of ED care, we have provided recommendations for restructuring care processes to promote shifts in clinical culture, evidence-informed decision-making, and proactive referral to community health services. References: Costa A, Hirdes JP, Ariño-Blasco S, Berg K, Boscart V, Carpenter CR, et al. interRAI Emergency Department (ED) Assessment System Manual: For use with the interRAI ED Screener (EDS) and ED Contact Assessment (ED-CA). Version 9.3. Washington, D.C.: interRAI; 2017.

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Hanley, Eileen. „The Role of Home Care in Palliative Care Services“. Care Management Journals 5, Nr. 3 (September 2004): 151–57. http://dx.doi.org/10.1891/cmaj.2004.5.3.151.

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This article addresses the increasing interest in end of life care and the need for improving access to palliative care services in patients/families served by the home care industry. The author discusses factors leading to this growing demand as well as some of the recent research conducted in the field of palliative care. The benefits of and underutilization of hospice services are discussed. The author addresses a variety of options for home care providers to consider expanding access to palliative care services including recent changes in regulation that allow for collaboration with Medicare certified hospice programs. A discussion of key topics to include in staff development initiatives related to palliative care is included as are education and clinical practice resources.

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Wright, Brenda. „Pharmaceutical Care in the Home Care Setting: Focus on Total Parenteral Nutrition“. Journal of Pharmacy Practice 7, Nr. 6 (Dezember 1994): 267–70. http://dx.doi.org/10.1177/089719009400700608.

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Cognitive services provided by the pharmacist have played a critical role in the successful development and implementation of home infusion services in the 1970s and 1980s. Pharmacists, working with the health care team that manages patients who receive infusion therapy in the home, used their clinical skills to support patients and other team members. They did this by evaluating patients before admission to the service, along with supporting the training, education, and monitoring of the patients receiving infusion therapy in the home. These services were provided on an ongoing basis.

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Brennan, Patricia Flatley, und Stefan Ripich. „Use of a Home-Care Computer Network by Persons With AIDS“. International Journal of Technology Assessment in Health Care 10, Nr. 2 (1994): 258–72. http://dx.doi.org/10.1017/s0266462300006218.

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AbstractComputer networks serve as convenient, efficient, and enduring vehicles for delivering nursing services to patients at home. The ComputerLink, a specialized computer network, provided nurse-supervised information, decision support, and communication services to home-dwelling persons living with AIDS (PWAs). During a 26-week randomized field experiment, 26 PWAs accessed the ComputerLink on more than 8,664 occasions. The communications area was used most often; the public communication area functioned like a support group. Multiple behavioral measures of use provide a rich picture of how these PWAs, none of whom had had prior computer experience, adopted and adapted to this innovative nursing care delivery system. Meeting the needs of a rapidly growing and diverse population of home-care clients demands that nurses make effective use of existing technologies such as cable television and telephone triage systems. Computer networks combine the best features of cable television and telephone systems—broadcast distribution and interaction; therefore, computer networks represent an ideal technology for the delivery of certain nursing services to the home.

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Draper, Brian, und Lee-Fay Low. „Psychiatric services for the “old” old“. International Psychogeriatrics 22, Nr. 4 (15.03.2010): 582–88. http://dx.doi.org/10.1017/s1041610210000293.

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ABSTRACTBackground: Few studies have specifically examined mental health service delivery to persons aged over 84 years, often described as the “old” old. Our aim was to compare mental health service provision in Australia to persons aged 85 years and over with the “young” old and other age groups. We hypothesized that the “old” old would differ from the “young” old (65–84 years) by diagnostic category, rates of specialist psychiatric hospital admission, and use of Medicare funded psychiatric consultations in the community.Methods: Mental health service delivery data for 2001–02 to 2005–06 was obtained from Medicare Australia on consultant psychiatrist office-based, home visit and private hospital services subsidized by the national healthcare program and the National Hospital Morbidity database for separations (admitted episodes of patient care) from all public and most private hospitals in Australia on measures of age, gender, psychiatric diagnosis, location and type of psychiatric care.Results: Use of specialist psychiatric services in the community per annum per 1000 persons declined with age in men and women from 137.28 and 191.87 respectively in those aged 20–64 years to 11.84 and 14.76 respectively in those over 84 years. However, men and women over 84 years received psychiatric home visits at 377% and 472% respectively of the rates of persons under 65. The annual hospital separation rate per 1000 persons for specialist psychiatric care was lowest in those aged over 84 (3.98) but for inpatient non-specialized psychiatric care was highest in those over 84 (21.20). Depression was the most common diagnosis in specialized psychiatric hospitalization in those aged over 84 while organic disorders predominated in non-specialized care in each age group over 64 years with the highest rates in those aged over 84.Conclusion: Mental health service delivery to persons aged over 84 is distinctly different to that provided to other aged groups being largely provided in non-specialist hospital and residential settings.

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Sinaga, Janno, Amila Amila und Evarina Sembiring. „MUTIARA HOME CARE“. JURNAL PENGABDIAN KEPADA MASYARAKAT 23, Nr. 4 (08.01.2018): 440. http://dx.doi.org/10.24114/jpkm.v23i4.8605.

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AbstrakTujuan jangka panjang pelaksanaan program Mutiara Home Care adalah menciptakan akses bagi terciptanya wirausaha baru, menunjang otonomi kampus perguruan tinggi melalui perolehan pendapatan mandiri. Bagi pasien program ini membantu meringankan biaya rawat inap yang makin mahal, karena mengurangi biaya akomodasi pasien, transportasi dan konsumsi keluarga. Dampak ekonomi nasional home care bagi pasien dan keluarga adalah semakin pendeknya hari rawat, sehingga jumlah klaim rumah sakit ke BPJS semakin rendah, sehingga berdampak bagi penurunan anggaran biaya perawatan masyarakat secara nasional. Produk Jasa Layanan Mutiara Home Care memiliki keunggulan dibandingkan home care lain. Pertama, Mutiara Home care akan dikelola dan diorganisir secara profesional oleh tenaga dosen profesional dibidang kesehatan dan keperawatan. Selama ini, home care dilakukan secara individu atau berkelompok tanpa wadah atau organisasi yang jelas. Tenaga kesehatan yang akan ditempatkan di komunitas atau di rumah telah terlatih dimulai sejak masa pendidikan dan tersertifikasi dari USM-Indonesia. Kedua, menyediakan layanan antar jemput pasien yang membutuhkan perawatan rumah sakit atau pemeriksaan khusus, seperti radiologi dan laboratorium. Layanan Mutiara Home Care pada tahap awal melayani pasien paska stroke dan perawatan lanjutan jantung, perawatan pasien DM dengan atau tanpa luka dan perawatan pasien lanjut usia. Secara bertahap akan dilakukan pengembangan serta layanan terhadap berbagai penyakit yang membutuhkan jasa perawatan profesional di rumah.Kata Kunci: Home care, MutiaraAbstractThe long-term goal of the Mutiara Home Care program is to create access to new entrepreneurs, to support college campus autonomy through the acquisition of independent income. For patients this program helps alleviate the cost of increasingly expensive hospitalization, as it reduces patient accommodation costs, transportation and family consumption. The national economic impact of home care for patients and families is the shortening of day care, so the number of hospital claims to BPJS is lower, thus impacting the reduction of national community maintenance budget. Products Care Services Pearl Home Care has advantages over other home care. First, Mutiara Home care will be managed and organized professionally by professional lecturers in the field of health and nursing. During this time, home care is done individually or in groups without a clear container or organization. Health workers who will be placed in the community or at home have been trained since the education and certified from USM-Indonesia. Secondly, it provides a shuttle service to patients who require hospital treatment or special examinations, such as radiology and laboratories. Pearl Home Care Services in the early stages of serving post-stroke patients and advanced heart care, treatment of DM patients with or without injuries and care of elderly patients. Gradually will be developed as well as services against various diseases that require professional care services at home.Keywords: Homecare, Mutiara

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McMillen, J. Curtis, Gregory B. Rideout, Rachel H. Fisher und Jayne Tucker. „Independent-Living Services: The Views of Former Foster Youth“. Families in Society: The Journal of Contemporary Social Services 78, Nr. 5 (Oktober 1997): 471–79. http://dx.doi.org/10.1606/1044-3894.816.

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Former consumers of independent-living programs for youth in out-of-home care present their views of the services they received. The youth found that skills classes and stipends for independent living were helpful, that instruction in managing a budget was particularly valuable, and that the services lessened the stigmatization and isolation of being in care. Foster parents and specialized independent-living workers eased the transition out of care, but regular public child welfare caseworkers were not helpful in this regard. The young people report that being in care was difficult to tolerate and that the transition out of care was often abrupt and difficult to manage.

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Szalontay, Andreea Silvana, Ilinca Untu, Dania Radu und Alexandra Boloș. „The therapeutic management of non-cognitive symptoms of dementia“. Psihiatru.ro 58 (3), Nr. 1 (24.09.2019): 6–9. http://dx.doi.org/10.26416/psih.58.3.2019.2523.

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It is estimated that, with the increase of the life expectancy of the population, one in two people at the age of 85 years old will have a form of dementia. This will represent a real burden for medical systems, and an increasing responsibility for their families and for society. The behavioral and psychological symptoms of dementia continue to receive insufficient attention. These symptoms can be observed some years before an adequate diagnosis of dementia, and they can be the first signs of alarm before the development of specific cognitive pathology. Patients suffering from dementia can benefit from integrated medical services, specialized care at home or at the hospital, day care services, specialized health services, memory assessment services, psychological and home care therapies, together with a specific drug therapy. Taking into account all of these aspects presented above, the aim of the paper is to analyze if an earlier diagnosis of dementia can be done in clinical practice, because the initiation of earlier treatment, in the mild-to-moderate phase, can lead to a considerable improvement of cognitive functions. In this context, as dementia is diagnosed earlier, an appropriate treatment can also improve the behavioral symptomatology. Also, a multidisciplinary approach can be of real help in assessing, anticipating and managing all these issues.

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Gagnon, Marie-Carmen, und Johanne Hébert. „Gaining a better understanding of the needs of rural cancer patients requiring in-home palliative and end-of-life care and nursing care and services“. Canadian Oncology Nursing Journal 33, Nr. 1 (31.01.2023): 46–60. http://dx.doi.org/10.5737/2368807633146.

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Issue: Access to in-home palliative and end-of-life care (PELC), qualified professionals, and high-quality nursing care and services in rural areas is limited and unequal, thus leading to an increase in unmet needs across the care trajectory of cancer patients. Objectives and methodology: A qualitative descriptive study was carried out to gain a better understanding of the needs of rural cancer patients receiving in-home PELC and to describe the nursing care and services available to them. Results: Five rural cancer patients requiring PELC reported a variety of needs, especially those arising from limited information resources and multiple time- and energy-consuming back-and-forth trips to urban centres. Seven nurses who provide in-home care and services to rural inhabitants outlined the challenges they face in addressing these needs. These are related primarily to the long distances they are called upon to travel, the limited number of specialized professional resources available, transfers to emergency departments, the dearth of PELC training and the lack of a dedicated PELC team. Conclusion: These findings helped gain a better understanding of the specific needs of rural cancer patients requiring in-home PELC, as well as the challenges that nurses must confront to help their patients remain in their own homes.

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Hand, Brittany N., Daniel L. Coury, Susan White, Amy R. Darragh, Susan Moffatt-Bruce, Lauren Harris, Anne Longo und Jennifer H. Garvin. „Specialized primary care medical home: A positive impact on continuity of care among autistic adults“. Autism, 09.09.2020, 136236132095396. http://dx.doi.org/10.1177/1362361320953967.

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While the medical home has proven effective at improving continuity of care among other populations, there is a paucity of literature testing the effectiveness of medical homes in serving the healthcare needs of autistic adults. We conducted a retrospective cohort study to compare the continuity of care of autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the Center for Autism Services and Transition (CAST), to propensity score matched national samples of autistic adults with private insurance or Medicare. The unadjusted median Bice–Boxerman continuity of care index was 0.6 (interquartile range = 0.4–1.0) for CAST patients, 0.5 (interquartile range = 0.3–1.0) for Medicare beneficiaries, and 0.6 (interquartile range = 0.4–1.0) for privately insured autistic adults. In multivariable models controlling for demographic characteristics, on average, CAST patients had continuity of care indices that were 10% higher than national samples of autistic adult Medicare beneficiaries (p < 0.0001). Continuity of care among CAST patients did not significantly differ from that of the national sample of privately insured autistic adults (p = 0.08). Our findings suggest that medical homes, like CAST, may be a promising solution to improve healthcare delivery for the growing population of autistic adults. Lay abstract There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the “medical home”. The medical home is not a residential home, but a system where a patient’s healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults.

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Landau, Aviv Y., Chinmayi Venkatram, Jiyoun Song, Maxim Topaz, Robert Klitzman, Jingjing Shang, Patricia Stone, Margaret McDonald und Bevin Cohen. „Home Care Clinicians' Perspectives on Advance Care Planning for Patients at Risk for Becoming Incapacitated With No Evident Advance Directives or Surrogates“. Journal of Hospice & Palliative Nursing, 10.02.2024. http://dx.doi.org/10.1097/njh.0000000000000998.

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Advance care planning is important and timely for patients receiving home health services; however, opportunities to facilitate awareness and engagement in this setting are often missed. This qualitative descriptive study elicited perspectives of home health nurses and social workers regarding barriers and facilitators to creating advance care plans in home health settings, with particular attention to patients with few familial or social contacts who can serve as surrogate decision-makers. We interviewed 15 clinicians employed in a large New York City–based home care agency in 2021-2022. Participants reported a multitude of barriers to supporting patients with advance care planning at the provider level (eg, lack of time and professional education, deferment, discomfort), patient level (lack of knowledge, mistrust, inadequate support, deferment, language barriers), and system level (eg, discontinuity of care, variations in advance care planning documents, legal concerns, lack of institutional protocols and centralized information). Participants noted that greater socialization and connection to existing educational resources regarding the intended purpose, scope, and applicability of advance directives could benefit home care patients.

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Chen, Bihui, Haili Zhu, Han Fu, Qiannan Han und Lei Chen. „A qualitative study on the willingness and influencing factors of master of geriatric nursing specialist postgraduates to volunteer for home respite care for disabled elderly families“. BMC Nursing 23, Nr. 1 (17.01.2024). http://dx.doi.org/10.1186/s12912-024-01710-9.

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Abstract Background As China’s population ages, the demand for care for the disabled elderly is increasing, and family caregivers find it challenging to meet the comprehensive care needs of the disabled elderly. Through home respite services, families of the disabled elderly can receive help and support from specialized nursing professionals to ease the burden on family caregivers and provide high-quality services. This study explores the willingness and influencing factors of Master of Geriatric Nursing Specialist postgraduates in China to volunteer to provide home respite services for disabled elderly individuals. Methods A qualitative study based on Grounded Theory used Strauss and Corbin’s programmatic version. A purposive sampling method was employed to conduct semi-structured interviews with 12 Master of Geriatric Nursing Specialist postgraduates from a tertiary hospital in Changsha, Hunan Province, China. Results The willingness of Master of Geriatric Nursing Specialist postgraduates to volunteer to provide home respite services for the disabled elderly was established as a core category, which was influenced by three main categories: personal factors, service object factors, and social factors, and nine categories formed from 39 initial concepts were included under the main category. Conclusions Influenced by China’s traditional cultural background, Master of Geriatric Nursing Specialist postgraduates in China have shown high motivation in volunteering to provide home respite services for the families of the disabled elderly but have been challenged by several challenges from China’s healthcare environment and education system. Relevant departments need to adopt a series of policies and measures to increase volunteers’ willingness to participate in respite care and promote its development.

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